Intergrating a Smoke-Free Home Intervention into the 5As to Support Cessation

将无烟家庭干预纳入 5A 以支持戒烟

• 批准号: 10442550
• 负责人: MICHELLE C KEGLER
• 金额: $ 64.49万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-04 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10442550
• 关键词: Address; Adoption; Advisory Committees; Alabama; Child; Communities; Data; Data Pooling; Environment; Evaluation Research; Federally Qualified Health Center; Florida; Home; Home environment; Household; Intervention; Intervention Studies; Low Income Population; Low income; Mind; Modeling; Ohio; Oklahoma; Outcome; Participant; Patients; Pharmacotherapy; Phase; Population; Population Analysis; Positioning Attribute; Prevention Research; Preventive service; Primary Health Care; Process; Provider; Randomized Controlled Trials; Reporting; Research; Rural; Rural Population; Site; Smoke; Smoke-free home; Smoker; Smoking; Testing; Time; Tobacco Control Research; Tobacco Use Cessation; Vulnerable Populations; cigarette smoke; cost; dissemination trial; effectiveness trial; efficacy testing; efficacy trial; environmental tobacco smoke exposure; follow-up; implementation evaluation; implementation outcomes; innovation; novel strategies; patient oriented; patient population; patient subsets; primary care setting; process evaluation; quitline; reduce tobacco use; safety net; service delivery; smoking cessation; smoking cue; social; socioeconomic disadvantage; treatment as usual

SUMMARY Establishing smoke-free homes may be a promising approach to support, and perhaps catalyze, smoking cessation. The inconvenience of going outside, combined with a reduction of environmental cues to smoke in the home, may result in less smoking and increased efforts to quit. Yet, no rigorous studies have tested the impact of creating smoke-free homes on cessation outside the context of protecting children from secondhand smoke exposure. We have developed a brief smoke-free homes intervention, “Some Things are Better Outside”, that is very effective in promoting the adoption of total smoking bans in low-income households. As part of NCI’s State and Community Tobacco Control research initiative, we conducted an efficacy trial, an effectiveness trial, a generalizability trial and a dissemination trial with positive outcomes in each phase of the research. Pooled data from our three RCTs, combined with results from a national dissemination study, document the potential of the intervention to support cessation. We propose to partner with two large federally qualified health centers (FQHCs) in rural south Georgia to rigorously test the efficacy and potential scalability of integrating a smoke-free homes intervention into the 5A (Ask, Advise, Assess, Assist, Arrange) approach for tobacco cessation recommended by the U.S. Preventive Services Task Force. FQHCs serve as the safety net of primary care for vulnerable populations in the U.S. Most FQHC patients are socioeconomically disadvantaged and represent a high priority for cessation. Developing and testing an approach for integrating the intervention into FQHCs from the outset should increase potential use of the intervention if proven effective. Our first aim is to adapt the intervention for integration into the 5As for tobacco cessation, followed by an RCT to test the efficacy of integrating the smoke-free homes intervention into the 5A approach for smoking cessation among FQHC patients. This approach may have broader reach than current approaches as it may appeal to those not yet ready to quit, as well as provide a social and physical personal environment that supports increased quit attempts and successful cessation. We also plan to conduct a multi-component process evaluation that examines implementation outcomes, cost and scalability potential. The proposed research will be the first to rigorously assess whether the integration of a strong smoke-free homes intervention into the 5As can encourage sustained smoking cessation in low-income patients.

总结 建立无烟家庭可能是一个有希望的方法来支持，也许催化，吸烟 停止外出的不便，加上减少环境线索吸烟 在家里，可能会导致吸烟减少和戒烟的努力增加。然而，没有严格的研究测试过 在保护儿童免受二手烟危害的范围之外， 烟雾暴露。我们制定了一个简短的无烟家庭干预措施，“有些事情更好， 在户外”，这对促进低收入家庭全面禁烟非常有效。作为 作为NCI州和社区烟草控制研究计划的一部分，我们进行了一项功效试验， 有效性试验、普遍性试验和传播试验，在每个阶段都取得了积极成果。 research.我们三项随机对照试验的汇总数据，结合一项全国性传播研究的结果， 记录支持戒烟的干预措施的潜力。我们建议与两个大型联邦政府合作， 在格鲁吉亚南部农村地区建立合格的卫生中心，严格测试其有效性和潜在的可扩展性。 将无烟家庭干预纳入5A（询问、建议、评估、协助、安排）方法， 美国预防服务工作组推荐的戒烟方法。联合国人道主义协调委员会作为安全网， 在美国的弱势群体的初级保健，大多数慢性丙型肝炎患者是社会经济 这是一个弱势群体，是停止的高度优先事项。开发和测试集成方法 从一开始就对非军事化的直升机进行干预，如果得到证实， 有效我们的第一个目标是调整干预措施，将其纳入戒烟的5A中， 一项随机对照试验，以测试将无烟家庭干预纳入吸烟5A方法的有效性 在慢性丙型肝炎患者中停药。这种方法可能比目前的方法具有更广泛的范围，因为它可能 吸引那些还没有准备好戒烟的人，并提供一个社会和个人环境， 支持增加戒烟尝试和成功戒烟。我们还计划进行一次多方面的 流程评估，检查实施结果、成本和可扩展性潜力。拟议 研究将是第一个严格评估是否整合一个强大的无烟家庭干预 5A可以鼓励低收入患者持续戒烟。